A patient is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will most likely be affected in this patient?
Elimination
Metabolism
Distribution
Absorption
The Correct Answer is A
Choice A reason: Elimination is the process of removing a drug from the body, usually through the kidneys or the liver. Acute renal failure is a condition where the kidneys suddenly lose their ability to filter waste products and excess fluid from the blood. This can impair the elimination of drugs that are mainly excreted by the kidneys, leading to increased drug levels and potential toxicity. The nurse should monitor the patient's renal function and adjust the dose of drugs that are renally eliminated.
Choice B reason: Metabolism is the process of transforming a drug into one or more metabolites, usually by enzymes in the liver. Acute renal failure does not directly affect the metabolism of drugs, unless it causes liver damage or alters the blood flow to the liver. The nurse should monitor the patient's liver function and the levels of drugs that are metabolized by the liver.
Choice C reason: Distribution is the process of transferring a drug from the blood to the tissues and organs of the body. Acute renal failure can affect the distribution of drugs that are bound to plasma proteins, such as albumin. When the kidneys are damaged, they may leak protein into the urine, causing hypoalbuminemia (low levels of albumin in the blood). This can increase the amount of free or unbound drug in the blood, which may enhance the drug's effect or cause adverse reactions. The nurse should monitor the patient's serum albumin level and the effects of drugs that are highly protein bound.
Choice D reason: Absorption is the process of moving a drug from the site of administration to the bloodstream. Acute renal failure does not directly affect the absorption of drugs, unless it causes changes in the gastrointestinal tract, such as edema, bleeding, or motility disorders. The nurse should monitor the patient's gastrointestinal function and the bioavailability of drugs that are administered orally.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason: Using a soft bristled tooth brush can prevent gum bleeding and irritation that may occur with a hard bristled tooth brush. Gum bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.
Choice B reason: Reporting black or bloody bowel movements is important because it can indicate gastrointestinal bleeding, which can be a serious complication of warfarin therapy. Gastrointestinal bleeding can cause anemia, shock, and even death if not treated promptly.
Choice C reason: Limiting all fruits and vegetables is not necessary for a client taking warfarin. However, some fruits and vegetables, especially those that are high in vitamin K, can interfere with the effect of warfarin and increase the risk of clotting. Vitamin K is found in green leafy vegetables, such as spinach, kale, broccoli, and cabbage, and some fruits, such as avocado, kiwi, and grapes. The client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.
Choice D reason: Reporting coffee ground or bloody emesis is also important because it can indicate upper gastrointestinal bleeding, which can be another serious complication of warfarin therapy. Upper gastrointestinal bleeding can cause hematemesis, melena, anemia, and hypovolemic shock.
Choice E reason: Shaving with an electric razor instead of a razor blade can prevent skin cuts and bleeding that may occur with a razor blade. Skin cuts and bleeding can be a sign of excessive anticoagulation and increased risk of bleeding.
Correct Answer is ["5"]
Explanation
To calculate the volume of hydrochlorothiazide oral solution that the nurse should administer per dose, we can use the following steps:
Determine the total daily dose:
The total daily dose is 150 mg.
Divide the total daily dose into 3 equally divided doses:
150 mg ÷ 3 = 50 mg per dose
Calculate the volume to be administered per dose:
The available oral solution has a concentration of 50 mg/5 mL.
50 mg ÷ 50 mg/5 mL = 5 mL
Therefore, the nurse should administer 5 mL of hydrochlorothiazide oral solution per dose.
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